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Published on: May 6, 2013
[Fulminant type 1 diabetes mellitus].
Akihisa Imagawa1, Toshiaki Hanafusa
1Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan. aimagawa@endmet.med.osaka-u.ac.jp
Rinsho Byori. the Japanese Journal of Clinical Pathology
|April 23, 2010
Summary
Fulminant type 1 diabetes is a rapid-onset diabetes subtype. It features near-complete beta cell destruction and may not meet standard diagnostic criteria, requiring medical attention to avoid misdiagnosis.
Area of Science:
- Endocrinology
- Immunology
- Pathology
Context:
- Fulminant type 1 diabetes is a distinct subtype of diabetes mellitus.
- Characterized by rapid pancreatic beta cell destruction.
- Prevalence in Japan estimated at 5,000-7,000 cases.
Purpose:
- To define the characteristics of fulminant type 1 diabetes.
- To highlight diagnostic challenges and criteria.
- To emphasize the need for clinical awareness.
Summary:
- Pathological findings include beta and alpha cell loss with mononuclear infiltration.
- Laboratory results show hyperglycemia, ketosis, elevated pancreatic enzymes, and absent autoantibodies (e.g., anti-GAD, anti-IA-2).
- Genetic associations with HLA-DR-DQ, CTLA-4, and HLA-B are noted.
Impact:
- Current diabetes diagnostic criteria (HbA1c ≥ 6.5%) may not apply to fulminant type 1 diabetes, as many present with HbA1c < 6.2%.
- Underscores the importance of recognizing this rapidly progressing form of diabetes.
- Aims to improve early detection and management by medical practitioners.
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